Yo-Ichi Yamashita1, Daisuke Imai2, Yuki Bekki2, Kazuki Takeishi3, Eiji Tsujita3, Toru Ikegami4, Tomoharu Yoshizumi2, Tetsuo Ikeda2, Ken Shirabe2, Teruyoshi Ishida3, Yoshihiko Maehara2. 1. Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan yamashi@surg2.med.kyushu-u.ac.jp. 2. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. 3. Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan. 4. Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Abstract
BACKGROUND: For eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC), anatomical resection is, in theory, preferable. PATIENTS AND METHODS: We carried-out a retrospective cohort study in 110 patients who underwent curative hepatic resection (anatomical resection; n=20, and limited resection; n=90) for solitary recurrent HCC from 1990-2010. RESULTS: No significant difference was found in short-term surgical results such as mortality, morbidity, and duration of hospital stay between the two groups. Anatomical resection did not influence overall and disease-free survival for all patients with a solitary recurrent HCC. In patients with cancer spread, such as pathological vascular invasion and intrahepatic metastasis (n=61), or with des-γ-carboxy prothrombin (DCP) ≥ 100 mAU/ml (n=73), the disease-free survival rate in the anatomical-resection group was significantly better than that in the limited-resection group (p=0.0452 and p=0.0345, respectively). CONCLUSION: Anatomical resection should be recommended only for HCC suspected of exhibiting cancer spread as reflected by DCP ≥ 100 mAU/ml in patients with solitary recurrent HCC. Copyright
BACKGROUND: For eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC), anatomical resection is, in theory, preferable. PATIENTS AND METHODS: We carried-out a retrospective cohort study in 110 patients who underwent curative hepatic resection (anatomical resection; n=20, and limited resection; n=90) for solitary recurrent HCC from 1990-2010. RESULTS: No significant difference was found in short-term surgical results such as mortality, morbidity, and duration of hospital stay between the two groups. Anatomical resection did not influence overall and disease-free survival for all patients with a solitary recurrent HCC. In patients with cancer spread, such as pathological vascular invasion and intrahepatic metastasis (n=61), or with des-γ-carboxy prothrombin (DCP) ≥ 100 mAU/ml (n=73), the disease-free survival rate in the anatomical-resection group was significantly better than that in the limited-resection group (p=0.0452 and p=0.0345, respectively). CONCLUSION: Anatomical resection should be recommended only for HCC suspected of exhibiting cancer spread as reflected by DCP ≥ 100 mAU/ml in patients with solitary recurrent HCC. Copyright